Smartphone Based Smoking Cessation Intervention for Socioeconomically Disadvantaged Adults

项目总结/摘要 在美国，吸烟是导致死亡和疾病的主要可预防原因。虽然多个诊所 基于电话的戒烟治疗已被证明是有效的，大多数戒烟尝试 都是不成功的此外，在社会经济上处于不利地位的成年人中， 与社会经济地位较高的成年人相比，以前的研究 指出了社会经济上处于不利地位的吸烟者中戒烟失败率高的多种原因 包括更多地接触其他吸烟者，更高的压力和尼古丁渴望。最近的一 研究发现，基于智能手机的生态瞬时评估（EMAs）可用于识别 在吸烟失效前的几个小时内，吸烟失效的风险很高。具体而言，EMA数据用于 创建一个六项吸烟失误风险估计器，可以在吸烟后4小时内识别出80%的吸烟失误 第一次失误该失效风险估计器被列为基于智能手机的Smart 治疗（Smart-T）戒烟应用程序。Smart-T应用程序多次评估吸烟失效的风险 并根据个人当前的失效风险自动定制治疗内容， 当前经历的失效触发器。Smart-T包括其他组件（例如，按需处理的提示 渴望，压力，情绪;戒烟的好处;一键呼叫戒烟热线;戒烟 药物治疗）。单组Smart-T初步研究（N=59）表明，3个月生化 经验证的戒烟率和EMA数据分析表明，定制的治疗内容减弱了靶向 失效触发器拟议研究（N=450）将比较Smart-T吸烟的长期影响 戒烟应用程序与免费和免费提供的NCI QuitGuide戒烟应用程序（目标1）。是 假设随机分配到Smart-T条件下的受试者中有显著更多的人会禁欲26 计划退出日期后的几周，比分配给QuitGuide应用程序的时间要长。 研究将确定是否智能T消息是专门针对解决关键的吸烟失效风险变量在真实的- 时间（即，敦促，压力，香烟的可用性，戒烟动机）降低这些失误风险的参与者评级 与没有收到此定制内容的类似情况相比，变量（QuitGuide组）。 可以使用自动化、量身定制、低负担和易于获得的干预措施， 弱势吸烟者，这一人群有很大的障碍，阻碍了他们使用传统的 戒烟治疗，戒烟。因此，这种干预有可能提供一个重要的 公共卫生影响到那些最需要它的人。

PROJECT SUMMARY/ABSTRACT Smoking is the leading preventable cause of death and disease in the United States. Although multiple clinic and phone based smoking cessation treatments have been proven effective, most smoking cessation attempts are unaided and unsuccessful. Furthermore, smoking prevalence in socioeconomically disadvantaged adults is higher and cessation rates are lower than among adults with higher socioeconomic status. Previous research has indicated multiple causes of high cessation failure among socioeconomically disadvantaged smokers including greater exposure to other smokers, and higher levels of stress and nicotine cravings. One recent study found that smartphone based ecological momentary assessments (EMAs) can be used to identify moments of high smoking lapse risk in the hours preceding a lapse. Specifically, EMA data were used to create a six-item smoking lapse risk estimator that identified 80% of all smoking lapses within 4 hours of the first lapse. This lapse risk estimator was included as a key component of the smartphone based Smart Treatment (Smart-T) smoking cessation app. The Smart-T app assesses risk for smoking lapse multiple times per day and automatically tailors treatment content based upon an individual's current risk for lapse and currently experienced lapse triggers. Smart-T includes other components (e.g., on demand tips for coping with cravings, stress, mood; benefits of quitting; one click call to the smoking cessation helpline; smoking cessation medication tips). The single arm Smart-T pilot study (N=59) indicated very promising 3 month biochemically verified cessation rates and analyses of EMA data indicated that tailored treatment content attenuated targeted lapse triggers. The proposed study (N=450) will compare the longer-term effects of the Smart-T smoking cessation app with the free and publically available NCI QuitGuide smoking cessation app (Aim 1). It is hypothesized that significantly more participants randomized to the Smart-T condition will be abstinent 26 weeks after a scheduled quit date than those assigned to the QuitGuide app. The second aim of the proposed study will determine if Smart-T messages that are tailored to address key smoking lapse risk variables in real- time (i.e., urge, stress, cigarette availability, cessation motivation) reduce participant ratings of these lapse risk variables compared with similar situations that do not receive this tailored content (QuitGuide group). Automated, tailored, low burden, and easily accessible interventions may be used to help socioeconomically disadvantaged smokers, a population with substantial barriers that have hampered the use of traditional smoking cessation treatments, to quit smoking. Thus, this intervention has the potential to deliver a significant public health impact to exactly those who need it most.